Umbilical hernia is a type of ventral hernia which may contain fat, omentum or bowel. According to the classification by the European Hernia Society, it is described as a hernia situated within 3 cm above or below the umbilicus. It is the second commonest type of hernia and makes up approximately 6%-14% of all abdominal wall hernias. Umbilical hernias have a narrow neck size hence the likelihood of strangulation and incarceration is higher. We report the case of a 53-year-old male who presented with septic shock requiring vasopressors secondary to a large necrotic umbilical hernia. The umbilical hernia has been present for years however not repaired due to his body mass index of more than 50. The overlying skin of the umbilical hernia appeared gangrenous with an offensive smell. Computed tomography of the abdomen showed a large fat-containing periumbilical anterior abdominal wall hernia. The hernia sac measures approximately 10.3 cm AP x 7.2 cm transverse x 7.2 cm craniocaudal. An urgent surgical debridement of the gangrenous umbilical hernia and primary closure of the fascial defect was performed. Intraoperative swab culture has grown Staphylococcus Aureus, Group A Streptococcus Pyogene and Aeromonas Hydrophila. This case highlights the importance of early hernia repair and the potential severe complications of umbilical hernia. Herein, we present and discuss images and highlight the importance of early diagnosis and treatment for gangrenous umbilical hernia in a rural setting to avoid life-threatening complications which may result from delayed or inadequate intervention.